Decisional Balance

Decisional Balance or Sitting on the Fence

When you make any decision in life you weigh up the pros and cons of the situation. The pros are all the things that you perceive as favourable, and thus supporting the decision. The cons are the downside and that you perceive as unfavourable, thus against the decision. This process is known as decisional balance and it is constantly going on, very often at a sub-conscious level. This model was first proposed by Janis and Mann in 19771. If you take something as simple as crossing the road, you look left and right and see if the road is clear. If there is a car approaching you might be thinking “if I run now I can beat the car, thus crossing quicker” that would be a pro. The other thought that may occur is “if I am not quick enough I may get run down” that would be a con. You now weigh up which is more important to you – crossing the road quickly or possibly being run down. Whichever you decide to go with you have made a decisional balance. Obviously, there are lots of other pros and cons you may also consider with this type of decision. This will all go on at a very sub-conscious level and you will be totally unaware of it. Let’s face it if you had to process this type of thing all the time you would frazzled from the effort. I think this highlights very well how much is going on at a subconscious level in your brain at any one time. I have said in previous articles that it is the subconscious brain that is running the show and this enforces that view. You are continually doing this for every action you take, although you may not be aware of it. The next time you decide to do something (anything in fact) try to work out what pros and cons you have thought through. This process is very important for weight management because it brings to a more conscious level some of your inner thoughts, these can then be addressed.

When you are working with a client who may be a bit ambivalent about losing weight or getting fit you will likely hear statements like “I really want to lose weight but I don’t want to have to give up my favourite foods” or “I am really keen to train regularly but I know gym memberships are expensive”. What you see in these two statements are the pros coming out first but very closely followed by the cons. It is just this type of client that motivational interviewing (MI) is designed for. Once trained in MI you will know how to recognise change language and then how to amplify this. What you are effectively doing is listening for the client’s pros towards whatever change it is you want to work on and then you help the client amplify these.

If somebody is fairly even/balanced in terms of pros and cons they may not be quite ready to change and may need more time to make the decision. We describe this as ‘being in a state of ambivalence’. These people are what we would call ‘contemplators’ in relation to the model for change2. From the perspective of a trainer working with a new client this is useful to understand from two points of view. First, we can measure a client’s readiness to change and the status of their decisional balance using psychometric testing. These psychometric tests are taught on the behaviour change workshop. Once we know where a client is from a psychological perspective we can now decide the best course of action moving forward.

Interestingly my research highlighted that clients will employ or approach a personal trainer even if (from a psychological perspective) they are not ready to change. This is important to understand because it means you can avoid taking on a client who ultimately will not achieve their goals. From the point of view of protecting your business integrity this is key. You do not want ex-clients telling others that you were not very much help. This won’t be accurate but unfortunately this type of client will apportion the blame on you as the trainer and not take responsibility for their own actions (or lack of them). What is worse you are not there when this happens to put your side of the story, ultimately then you do not want to take on a client in this scenario.

That said if you do take on this type of client then you can undertake a psychometric assessment and decide if this prospective client is ambivalent about losing weight or getting fit (they are not quite sure in their own minds, at least sub-consciously) then you can act on this. Motivational interviewing will allow you to address this ambivalence and with skill move the client to a point where they are ready to change. In other words, what you can do is shift the balance so that the pros outweigh the cons. I stated, “with skill move the client” and although ultimately this is the outcome it is actually more accurate to state “that the client can decide to move forward”. All you do in this scenario is facilitate that forward movement and you achieve this using motivational interviewing skills.

The other useful aspect of doing this type of continual psychological assessment is that it will help you measure how successful your training and nutrition programmes are. By measuring decisional balance regularly, you can predict which direction a client is moving. What you should see with time is the pros either increasing (or at least remaining static) and the cons decreasing. My research has highlighted that you need a certain gap between the pros and cons before a client will be successful in a weight management programme. This initial gap needs to be sustained and ideally increased. If you see this happening you can be confident that your programmes are working. The flip side of this is that if you measure a client and see the opposite happening you can act before you lose the client. I describe this as catching the client before they fall.

This article has hopefully highlighted the importance of psychological assessment and the value of understanding where a client is in terms of their decisional balance. It has also demonstrated that with the right skill set you can work with a client regardless of their decisional balance status and achieve positive results.